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[Jane50]

Hi all,

I'm currently on 5 pumps oestrogel and 200mg utro on a sequi regime.

I'm still having hot flushes, night sweats and night time cortisol surges.

Possibly not absorbing gel very well? Dr Currie advised trying a switch to Estradot with the utro to see if different delivery method would help.

Requested this from GP today and they said they're not licensed to prescribe Estradot and utrogestan together.

 

[Uptick]

That can't be right 

[sheila99]

It doesn't sound right. What did they suggest instead?

[Jane50]

She suggested the Mirena and Estradot or a continuous HRT. I've asked to be referred back to gynae. I don't want either of those. I'm happy (ish!) on utro and just need the oestrogen sorting. Honestly, you'd think menopause was a new phenomenon the lack of expertise there is!

[Uptick]

Hi Jane50, are you peri or postmenopausal?

[Jane50]

Hi uptick, I'm peri. Been on oestrogel for about a year, slowly creeping up from 2 pumps to 5.

[Uptick]

Thanks Jane50, I thought that maybe you GP had refused Estradot based on the new PIL that states Estradot is only for postmenopausal women 

1. What Estradot is and what it is used for
Estradot is a Hormone Replacement Therapy (HRT). It contains the female hormone oestrogen. Estradot is used in postmenopausal women with at least 12 months since their last natural period. Estradot comes as a patch that is applied to the skin.
Estradot is used for:
Relief of symptoms occurring after menopause
During the menopause, the amount of oestrogen produced by a woman’s body drops. This can cause symptoms such as hot face, neck and chest ("hot flushes"). Estradot alleviates these symptoms after menopause. You will only be prescribed Estradot if your symptoms seriously hinder your daily life.
Prevention of osteoporosis (for Estradot 50, 75 and 100 only)
After the menopause some women may develop fragile bones (osteoporosis). You should discuss all available options with your doctor.
If you are at an increased risk of fractures due to osteoporosis and other medicines are not suitable for you, you can use Estradot to prevent osteoporosis after menopause.

[Jane50]

Hhmm, thanks uptick. Perhaps, but her issue seemed to be it's combo with utro 🤷

[Uptick]

Well, if that's the case, it's absolutely ridiculous.

[sheila99]

I'm pretty sure hurdity was an estradot and utrogeston before the estradot shortage.
Any idea why it should be for post meno only? Surely oestrogen is oestrogen.

[Uptick]

Tbh I don't know exactly what has changed regarding that section of Estradot's leaflet. All the emc website says it's that it has been changed today. I don't have the older leaflets any more.

I think they say it's for postmenopausal women because it's supposed to replace oestrogen levels and during perimenopause they are usually oscillating and not necessarily low. But of course it can be used by perimenopausal women, it just won't be necessarily effective if oestrogen levels are peaking at extremely high levels.

[sheila99]

Must have been written a man! So in peri you get symptoms because you're deficient in oestrogen but you can't have oestrogen because for 3 days in the 5 years you suffer you might have too much oestrogen instead of too little. 

[Uptick]

I suppose it's because high levels of oestrogen would be necessary to control symptoms in perimenopause and the highest dose available in patches (100mcg) wouldn't be enough.

[sheila99]

Wouldn't it? I may have the doses wrong but I thought 50mg evorel patch, 2 pumps oestrogel and 50 estradot patch were all roughly equivalent? So estradot comes in more or less the same dose as other brands?
I was going to ask for estradot as it will be easier to apply than gel. Late peri now.

[Jane50]

I thought the Estradot 100 patch was equivalent to 4 pumps oestrogel?  It's what it has to do with the utrogestan that's befuddling.. as if I'm not doolally enough already!